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Consuming Low Doses of Peanut after Being Desensitized with Peanut Oral Immunotherapy Can Produce Sustained Unresponsiveness

SAN DIEGO, CA – Research has shown that peanut oral immunotherapy can produce
desensitization and even sustained unresponsiveness, or the ability to eat peanut without an allergic response to it. Yet what is the optimal dose needed to produce sustained
unresponsiveness? A study presented at the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) investigated this question.

“Encouraging continued peanut consumption after reaching the point of desensitization is one of the challenges of oral immunotherapy. In light of that, our goal was to find out if consuming just a small amount of peanut would be enough to allow for sustained unresponsiveness,” said Scott P. Commins, MD, PhD, one of the study authors.

To find answers, researchers gave twenty peanut-allergic subjects between the ages of 4 and 19 peanut oral immunotherapy. A food challenge to assess desensitization was performed after a year. The subjects were then transitioned to consuming one to two peanuts daily, or approximately 300 to 600 milligrams (mg) of peanut protein. Once serum peanut-specific IgE was less than 15 IU/mL, they underwent a second food challenge following four weeks of intentionally avoiding eating peanut. Sustained unresponsiveness was marked by passing this second food challenge.

Seventeen of 20 subjects achieved desensitization, passing the first oral food challenge that had them each consume 5,000 mg of peanut protein. Three subjects withdrew from the study due to side effects.

After desensitization, 10 subjects continued consuming one to two peanuts daily at home for a median of 8.7 months until serum peanut-specific IgE was less than 15 IU/mL. All 10 passed the second food challenge, which had them consume another 5,000 mg of peanut protein following a four week avoidance period. Seven continued to eat the one to two peanuts a day dose, as their serum peanut-specific IgE had yet to fall to less than 15 IU/mL.

“From our results, the small one to two peanuts daily maintenance dose appeared very effective in producing sustained unresponsiveness,” said Dr. Commins.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health
professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,800 members in the United States, Canada and 60 other countries.

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Editor's notes:
· This study was presented during the 2014 Annual Meeting of the American Academy of
Allergy, Asthma & Immunology (AAAAI) on February 28-March 4 in San Diego.
However, they do not necessarily reflect the policies or the opinions of the AAAAI.
· A link to all abstracts presented at the Annual Meeting is available atannualmeeting.aaaai.org. (Note to media: see abstract 360)